ECONOMIC-EVALUATION OF DRUGS IN PERIPHERAL VASCULAR-DISEASE AND STROKE

Increased pressures on health-care budgets mean that governments requi re good value for money from the resources devoted to health care. In many countries, measures have been introduced to increase efficiency o r to contain health-care costs. These include price controls, limitati ons on reimbursement of health technologies, budgetary reform in healt h-care institutions, and the encouragement of competition. Given this changing environment, it is important that drugs and other health tech nologies be shown to give good value for money. The methods of economi c evaluation, such as cost-benefit and cost-effectiveness analysis, ca n be used to assess the value of drugs and other health technologies. They have been widely applied. The economic evaluation of drugs in per ipheral vascular disease and stroke would compare the cost of adding t he drug with its benefits. These would include improvements in length and quality of life and the savings in treating vascular events that m ay be postponed, or lessened in intensity, by effective drug therapy. One study, following a clinical trial of naftidrofuryl in stroke, sugg ested that there would be significant reductions in costs through redu ctions in hospital stay if recovery was aided. Further research and a large multicenter trial are under way to confirm these findings. In pe ripheral artery disease there are no economic data collected alongside clinical trials. It is known, however, that the costs of leg ischemia can be significant. A study in the U.K. found that arterial construct ion would cost around pound 7,750 per person (1989 prices) and amputat ion around pound 11,000 per person. Therefore, the costs of drug thera py need to be balanced against the costs of treating progressive disea se and the consequent reductions in quality of life for the patient.